The URL can be used to link to this page

Home My WebLink AboutEvans ® °''"� ' ' "`' r�1 Town Hall, 53095 Main Road -*QP . (2) P.O. Box 1179 �® i! Southold, New York 11971 JUDITH T.TERRY /1/'' FAX(516)765-1823 ��/ TELEPHONE(516)765-1801 TOWN CLERK REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 1419-R Residential X Non-Residential Fee $ 10.00 Septic Cesspool X New Existing X Name Of Owner EVANS, BRIAN Mailing Address 1 RR 3, 900 ALVAHS LANE Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 900 ALVAHS LANE Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-5797 Tax Map No. section 109.00 block 2 lot 1 .000 Cross Street ROUTE 25 Date Of Last Pump Out 0/00/00 Issue Date: 3/16/90 Judith T. Terry Southold Town Clerk (TOWN SEAL) „ III OFFICE,,,O x THE TOWN CLERK AWFO(A' c Town of Southold CQG Application No. /y/9_ Judith T. Terry, Town Clerk 01. 61 ` . :! Town Hall, 53095 Main Road ar,s $10.00 - Residential P. O. Box '1179 tri Zr !-W.`,4 i • $25.00 - Non-Residential Southold, New York 11971sJ Telephone �� (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for - - OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ /6,:03 DATE J2(//Z,)/59, 'OWNER NAME: 6 p , dt.) cmA.J 5 • • OWNER MAILING ADDRESS: j 7dD au 14)5 �sJC �0- c•//oy ue l litJ,�, / 193 .OWNER PROPERTY ADDRESS: (_25A-m — - OWNER TELEPHONE NUMBER: 75 7 -- TAX MAP NO. : Section /07 Block a Lot f CROSS STREET: PTC._ ) 1 U/9 n°5 ) ' TYPE OF -SYSTEM: Septic Tank New Existing ACesspool3 ✓ New Existing v Residential V Non-Residential DATE OF PREVIOUS PUMP-OUT: LOCATION MAP: Must be attached hereto before permit may be issued. (Locate building and system; give north arrow and feet of distance, approximately, to building and closest road.) ec,„Signature of Applicant RECEIVED BY: -, Town Clerk's Office - • DATE: _ - --=-� �� . °, �� ^~ . . I - --/ - _- -_--__ �� .... ��n - _-� __- __ - - -__ --•--- / � __ -- - --__--_ -- • --_~~- 6 � �� 7o �� /-- . ~ � �^ 9/0�� ~� iDy1v� . , ^ ' ' -- ��--Roo�--� -------- -- .c goo > / . ~~-___ �� . c:;) . ' ��v ;�" � / -_" .'^ I � n -__.___- _ __-_- / -- ' zp / ,...7.1 ^ / ^ = -~ �� _~ - ' / | / b 0 , � 1 /i --_-~ ii 2% ! � __� ____---_ �'.-_ -'.,_-_ ! ' !--~ - - - -- - | / ___' ___ _ --- k _ _ -- -- --- --- - - - � --- ---| _ ! _ �� _ ~~- �� _ _ _ �- __' _ --- --| ----' - - ---- | -- -- -| --- ----- - - ! -| -' � '